Ruth DeSouza

RMIT University, RMIT School of Art, Faculty Member

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Situating ‘careful surveillance’

International Journal of Cultural Studies

In this article we explore preliminary findings from the study COVIDSafe and Beyond: Perceptions ... more In this article we explore preliminary findings from the study COVIDSafe and Beyond: Perceptions and Practices conducted in Australia in 2020. The study involved a survey followed by interviews, and aimed to capture the dynamic ways in which members of the Australian public perceive the impact of Covid practices – especially public health measures like the introduction of physical and social distancing, compulsory mask wearing, and contact tracing. In the rescripting of public space, different notions of formal and informal surveillance, along with different textures of mediated and social care, appeared. In this article, we explore perceptions around divergent forms of surveillance across social, technological, governmental modes, and the relationship of surveillance to care in our media and cultural practices. What does it mean to care for self and others during a pandemic? How does care get enacted in, and through, media interfaces and public interaction?

Intersectionality, Resistance, and History-Making: A Conversation Between Carolyn D'Cruz, Ruth DeSouza, Samia Khatun, and Crystal McKinnon, Facilitated by Jordana Silverstein

A good, solid, history-writing practice is one which, I think, shakes people's ideas of the w... more A good, solid, history-writing practice is one which, I think, shakes people's ideas of the world and their place in it, compelling them to imagine new social, cultural and political formations which can provide an account of life. Kimberle Crenshaw's development of the term 'intersectionality', and the ways it has been taken up by people of colour within the academy internationally, as well as by activists, provides one example of such imaginative work. Because when you spend some time in the Australian History academic scene, at conferences, in departments, talking to other academics, it's quickly noticeable that one of its key features is its hegemonic whiteness. Even in those spaces that aspire to avoid whiteness, it's inescapable, visible daily, as well as in the themes at conferences, the keynote speakers chosen, the food served, the knowledge shared. When it came time for the Australian Women's History Network conference in 2016, which carried the ...

Hearing Different Voices: Methodological Pluralism in Nursing Education and Research

This paper discusses the need for multi-cultural methodologies that develop knowledge about the m... more This paper discusses the need for multi-cultural methodologies that develop knowledge about the maternity experience of migrant women themselves and that are attuned to women's maternity related requirements under multi-cultural conditions. The birth of a child is one of the most culturally and spiritually significant events for women and their families, often validated through ritual. Studies show that cultures with supportive rituals for new mothers have lower rates of postnatal distress (PND) and that women in Western countries are at high risk of developing PND. The medical model assumes that because the physiology of childbirth is universal, all mothers experience the transition to parenthood in the same way, however, childbirth is conceptualised, structured and experienced differently according to culture. Like childbirth, migration is also a life changing experience, yet how the transition to parenthood occurs for mothers in a new country is an area where little research has been undertaken particularly in New Zealand. In this paper I will explore the literature around motherhood and migration with particular focus on the stereotypical views of migrant mothers as problematic and different rather than diverse and rich. I will challenge the positivist hegemony of previously completed research on migrant women by reflecting on my own experience as a researcher grounded in a broadly-based, pluralistic set of critical epistemologies that allowed me to uncover the issues and contexts that impacted on the experience of migrant women. It is my hope that by doing this I can contribute to changes in nursing education and research such that the voices of minority groups are heard and better health outcomes result.

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practice in Aotearoa New Zealand

societies: implications for cultural safety in nursing

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Motherhood, Migration and Methodology: Giving Voice to the Other

The Qualitative Report

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Culture and mental health care in New Zealand: indigenous and non-indigenous people

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Returning the indigenous to the centre: a view from Aotearoa/New Zealand

Diversity and equality in health and care, 2009

Colonisation continues to underpin social identities and relationships in Aotearoa/New Zealand. I... more Colonisation continues to underpin social identities and relationships in Aotearoa/New Zealand. In this editorial we examine these identities and relationships, pointing out that arguments are frequently made against indigenous Maori rights in favour of the rights of other visibly different communities, such as Pacific peoples and ethnic communities. This construction of competing Others is a key technique through which unequal power relationships and the dominance of white-settler institutions are maintained in Aotearoa/ New Zealand. We suggest that, with our population projections predicted to make Aotearoa/New Zealand browner and our health workforce increasingly diverse, these social identities and relationships warrant further attention. We advocate for the centrality of Maori rights and the fulfilment of these rights, in order to provide a basis for a broader social justice agenda working for the elimination of both ethnic inequalities in health and racial discrimination more ...

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New Zealand Wellness for all : the possibilities of cultural safety and cultural competence in

Responses to cultural diversity in nursing need to consider the theory and practice developments ... more Responses to cultural diversity in nursing need to consider the theory and practice developments of the profession, whilst also responding to broader social and historical process that prevent marginalised groups from utilising universal health services. A combination of approaches is suggested in this paper to meet these two imperatives. Cultural safety is one indigenous New Zealand nursing approach derived in response to inequalities for Maori, whereas cultural competence is an imported paradigm derived from a multicultural context. Furthermore, research and dialogue are required to examine points of complementarity and tension. This paper offers a beginning for this process.

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Researching with Communities

New Spaces and Possibilities: The Adjustment to Parenthood for New Migrant Mothers

Migrant women who become new mothers in New Zealand say their cultural needs are often not met or... more Migrant women who become new mothers in New Zealand say their cultural needs are often not met or understood by health professionals. Funded by the New Zealand Families Commission "Blue Skies Fund", the researchers interviewed 40 Chinese, Korean, South African, British, American, Indian, Palestinian and Iraqi women about their experience of pregnancy and birth in New Zealand.The report's author Ruth DeSouza of AUT University's Centre for Asian and Migrant Health Research, makes a range of recommendations as a result of the study. These include making improvements to support services and communication, providing translations of relevant information, and above all the development of an enhanced degree of cultural comptence amongst service providers.

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Walking upright here : countering prevailing discourses through reflexivity and methodological pluralism : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Arts in Nursing at Massey University, Albany, New Zealand

Knowledge development takes place in the context of competing political, social and economic fram... more Knowledge development takes place in the context of competing political, social and economic frameworks that often reflect dominant group values, practises and ideologies. Research scholarship needs to include and legitimate knowledge construction from different locations and epistemologies. Where research occurs with minority groups it is suggested that multiple research strategies are incorporated in order to prevent the reproduction of deficiency discourses. Such strategies could include self-reflexivity and the use of methodological pluralism, incorporating appropriate methodologies that can be used to expose and dismantle hegemonic discourses. A research exemplar is used that features the dual transition of migration and motherhood for women from Goa, India who are now living in New Zealand. This is done to illustrate the applicability of reflexivity and methodological pluralism in countering the hegemonic deficiency discourse associated with migrant women. The qualitative appr...

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Accessing nursing workforce information

Providing culturally safe care

ABSTRACT , , E., &amp; De Souza, R. (2009). Providing culturally safe care In P. Barker (Ed.)... more

Navigating the ethics in cultural safety

Cultural Safety in Aotearoa New Zealand

Caring is an ethical activity with a deep moral commitment that relies on a trusting relationship... more Caring is an ethical activity with a deep moral commitment that relies on a trusting relationship (Holstein &amp; Mitzen, 2001). Health professionals are expected to be caring, skilful, and knowledgeable providers of appropriate and effective care to vulnerable people. Through universal services they are expected to meet the needs of both individual clients and broader communities, which are activities requiring sensitivity and responsiveness. In an increasingly complex globalised world, ethical reflection is required so that practitioners can recognise plurality: in illness explanations; in treatment systems; in the varying roles of family/whanau or community in decision making; and in the range of values around interventions and outcomes. To work effectively in multiple contexts, practitioners must be able to morally locate their practice in both historical legacies of their institutional world and the diversifying community environment. This chapter examines the frameworks that health professionals can use for cross-cultural interactions.I then explore how they can select the most appropriate one depending on the person or group being cared for.

Culturally safe care for ethnically and religiously diverse communities

Cultural Safety in Aotearoa New Zealand

Cultural safety is borne from a specific challenge from indigenous nurses to Western healthcare s... more Cultural safety is borne from a specific challenge from indigenous nurses to Western healthcare systems.It is increasingly being developed by scholars and practitioners as a methodological imperative toward universal health care in a culturally diverse world. The extension of cultural safety, outside an indigenous context, reflects two issues: a theoretical concern with the culture of healthcare systems and the pragmatic challenges of competently caring for ethnically and religiously diverse communities. As discussed throughout this book, the term ‘culture’ covers an enormous domain and a precise definition is not straightforward. For the Nursing Council of New Zealand (‘the Nursing Council’) (2009), for example, ‘culture includes, but is not restricted to, age or generation; gender; sexual orientation; occupation and socioeconomic status; ethnic origin or migrant experience; religious or spiritual belief; and disability’. In an attempt at a precise two-page definition, Gayatri Chakravorty Spivak (2006, p. 359), captures the reflexive orientation required to grasp how the term ‘culture’ works: Every definition or description of culture comes from the cultural assumptions of the investigator. Euro-US academic culture… is so widespread and powerful that it is thought of as transparent and capable of reporting on all cultures. […] Cultural information should be received proactively, as always open-ended, always susceptible to a changed understanding. […] Culture is a package of largely unacknowledged assumptions, loosely held by a loosely outlined group of people, mapping negotiations between the sacred and the profane, and the relationship between the sexes. Spivak’s discussion of the sacred and the profane links culture to the more formal institution of religion, which has historically provided the main discourse for discussion of cultural difference. Particularly important for cultural safety is her discussion of Euro-US academic culture, a ‘culture of no culture’, which has a specific lineage in the sciences of European Protestantantism. Through much of the 19th century, for example, compatibility with Christianity was largely assumed and required in scientific and medical knowledge, even as scientists began to remove explicit Christian references from their literature. This historical perspective helps us see how the technoscientific world of the healthcare system, and those of us in secular education, are working in the legacy of white Christian ideals, where the presence of other cultures becomes a ‘problem’ requiring ‘solutions’. Cultural safety, however, attempts to locate the problem where change can be achieved in the healthcare system itself.

Patient-generated health data management and quality challenges in remote patient monitoring

JAMIA Open

Background Patient-Generated Health Data (PGHD) in remote monitoring programs is a promising sour... more Background Patient-Generated Health Data (PGHD) in remote monitoring programs is a promising source of precise, personalized data, encouraged by expanding growth in the health technologies market. However, PGHD utilization in clinical settings is low. One of the critical challenges that impedes confident clinical use of PGHD is that these data are not managed according to any recognized approach for data quality assurance. Objective This article aims to identify the PGHD management and quality challenges that such an approach must address, as these are expressed by key PGHD stakeholder groups. Materials and Methods In-depth interviews were conducted with 20 experts who have experience in the use of PGHD in remote patient monitoring, including: healthcare providers, health information professionals within clinical settings, and commercial providers of remote monitoring solutions. Participants were asked to describe PGHD management processes in the remote monitoring programs in which ...

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Review: Nurses’ views on the impact of mass media on the public perception of nursing and nurse–service user interactions

Journal of Research in Nursing

Mass media comprises the storytellers and portrayers of our social worlds (Nairn et al., 2014), a... more Mass media comprises the storytellers and portrayers of our social worlds (Nairn et al., 2014), and has a central role in reproducing the contradictory views held about nurses by the public. As the reviewed paper shows, media representations are far from harmless: they influence public understanding and confidence in the profession and impact on recruitment, policy and nurses&#39; self-image (Kalisch et al., 2007). Nurses are considered highly trustworthy by the public due to their virtues of care and compassion. However, the dominant representations of nurses in the media are often inaccurate, erasing male nurses from the profession and downplaying the autonomous judgement of the nursing professional. Nurses as feminised handmaidens play a subordinate support role to medical decision makers. The media nurse engages in bedside routines and repetitive tasks, and is sometimes a sex object, an angel of mercy or a battleaxe, sometimes all three. These stereotypical representations have changed over time, and sometimes nurses are depicted as strong and confident professionals (Kalisch et al., 1981; Stanley, 2008). Yet the significant professional, theoretical and scholarly innovations that have reshaped the role of nurses are largely invisible to the public (Ten Hoeve et al., 2014). In tandem with nursing&#39;s processes of professionalisation, austerity measures in the neoliberal health system have demanded efficiency and cost containment, while also reorienting services so they can be more client-centred. This twin move to the proletarianisation of nursing care (through the growth of various classes of healthcare assistants doing tasks previously performed by nurses) and democratisation of health within a technocratic, market-led and more participatory health system has profound implications for the future of nursing. The reviewed paper is timely, given the growing focus on shared decision making and participation as an outcome of client-centredness in Western health systems. It raises

Quality Assurance of Health Wearables Data – A Participatory Workshop (Preprint)

BACKGROUND The ubiquity of health wearables and consequently, the production of patient-generated... more BACKGROUND The ubiquity of health wearables and consequently, the production of patient-generated health data [PGHD] is rapidly escalating. However, the utilisation of PGHD in routine clinical practices is still low due to data quality obstacles. As there is no agreed approach to PGHD quality assurance, realising the promise of PGHD requires in-depth discussion among diverse PGHD stakeholders to identify the challenges they face and to understand their needs for PGHD quality assurance. OBJECTIVE A participatory workshop aimed to explore stakeholders’ data quality challenges, identify their needs and expectations and to offer practical solutions. METHODS A qualitative multi-stakeholder workshop was conducted as a half-day event in the Melbourne Parkville Precinct. The 18 participants were members of the public who had experience of PGHD use in clinical care, including people who identified as healthcare consumers, clinical care providers, wearables suppliers, and health information s...

Teaching ethics: Intersectionality, care failure and moral courage

Nurse Education Today

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Review: Australian mental health nurses and transgender clients: Attitudes and knowledge

Journal of Research in Nursing

Ruth DeSouza

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